The treatment landscape of bladder cancer has undergone a transformation in the last few years, most notably with the approval of 5 checkpoint inhibitors. With all of these new options, Matthew Galsky, MD, said that the question now is whether immunotherapy is more beneficial as a monotherapy or in combination.

, Galsky, professor of medicine, hematology, and medical oncology, Mount Sinai Hospital, discussed these studies, as well as the future for chemotherapy in bladder cancer.

OncLive: Can you provide some background information on these trials?

Galsky: The first-line treatment of [patients with] metastatic bladder cancer has been chemotherapy for the past several decades—either cisplatin-based in eligible patients, or carboplatin-based for those who are cisplatin-ineligible. We know that chemotherapy has a response rate of about 30% to 50% in patients with metastatic bladder cancer, particularly with cisplatin-based therapy. A small proportion of those patients will have durable responses, but for the majority of patients, the responses are relatively short-lived and, ultimately, patients progress.
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